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Phase II Study of TPA Plus Dexamethasone & CMT in Hematologic Malignancies

Primary Purpose

Leukemia

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
12-O-tetradecanoylphorbol-13-acetate
Dexamethasone
Choline magnesium trisalicylate
Sponsored by
Rutgers, The State University of New Jersey
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia focused on measuring Acute Myelogenous Leukemia, Relapsed AML, Refractory AML

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Must have a histologically documented relapsed/refractory AML for which there is no standard therapy that has been demonstrated to have curative or palliative potential.
  • ECOG performance status of 0-2.
  • Must be 18 years or older.
  • Estimated life expectancy > 1 month.
  • Laboratory data:

    • total bilirubin ≤ 1.5 x upper limit of normal unless due to Gilbert's syndrome
    • serum creatinine ≤ 2.0 mg/dl
    • AST ≤ 3.0 x upper limit of normal
    • Cardiac ejection fraction > 40%
    • FEV1.0 > 50% predicted
  • Prior therapy: > 3 weeks since chemotherapy, biological therapy or radiation; anticipated maximum hematological improvement since last dose of chemotherapy. (Concurrent hydroxyurea administration will be allowed to control WBC count, platelet count, or symptoms).
  • No active infections.
  • Negative pregnancy test for women of childbearing potential.
  • No uncontrolled psychiatric illness or medical illness that the principal investigator feels will compromise the patient's tolerance of the study medication.
  • Must provide informed consent.

Exclusion Criteria

  • Patients with an allergy to proton pump inhibitors, required for GI prophylaxis; or salicylates are excluded.
  • Pregnant or lactating women
  • Age <18 years. Because no dosing or adverse event data are currently available on the use of TPA alone or in combination with dexamethasone in patients < 18 years of age, children are excluded from this study but will be eligible for future pediatric Phase II combination trials.
  • The effects of TPA on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation and for 10 weeks after. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Should the female partner of a participant in this study become pregnant or suspect she is pregnant during this study, the PI of this study will be available to provide advice about further medical/obstetric care/referral for the female partner.
  • Patients with active CNS involvement (documented by radiographic lesions and/or malignant cells in the CSF) will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  • Patients with treatment of any other investigational drug within the last 30 days prior to entering the study.

Sites / Locations

  • Rutgers Cancer Institute of New Jersey

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TPA + Dexamethasone and CMT

Arm Description

12-O-tetradecanoylphorbol-13-acetate (TPA) plus Dexamethasone & Choline magnesium trisalicylate (Trilisate)

Outcomes

Primary Outcome Measures

Response Rate > 20% for 12-O-tetradecanoylphorbol-13- Acetate (TPA)+ Dexamethasone + Choline Magnesium Trisalicylate(Trilisate)
Grade 3 and 4 Non-hematologic Treatment-related Toxicity Rates < 25%

Secondary Outcome Measures

Effects of Treatment on Immunophenotype, Signaling Profile, and Nuclear NF-kB Expression
Cycle 1 of treatment

Full Information

First Posted
November 6, 2009
Last Updated
November 2, 2015
Sponsor
Rutgers, The State University of New Jersey
Collaborators
Rutgers Cancer Institute of New Jersey, National Cancer Institute (NCI), Biosuccess Biotech Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01009931
Brief Title
Phase II Study of TPA Plus Dexamethasone & CMT in Hematologic Malignancies
Official Title
A Phase II Study of 12-O-tetradecanoylphorbol-13-acetate (TPA) Plus Dexamethasone & Choline Magnesium Trisalicylate in the Treatment of Patients With Relapsed/Refractory Acute Myelogenous Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
November 2015
Overall Recruitment Status
Terminated
Why Stopped
Study was terminated early due to lack of experimental medication (supply issues)
Study Start Date
March 2011 (undefined)
Primary Completion Date
October 2011 (Actual)
Study Completion Date
September 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rutgers, The State University of New Jersey
Collaborators
Rutgers Cancer Institute of New Jersey, National Cancer Institute (NCI), Biosuccess Biotech Co., Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This phase II trial is studying the side effects and how well giving tetradecanoylphorbol acetate together with dexamethasone and choline magnesium trisalicylate works in treating patients with relapsed or refractory acute myeloid leukemia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia
Keywords
Acute Myelogenous Leukemia, Relapsed AML, Refractory AML

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TPA + Dexamethasone and CMT
Arm Type
Experimental
Arm Description
12-O-tetradecanoylphorbol-13-acetate (TPA) plus Dexamethasone & Choline magnesium trisalicylate (Trilisate)
Intervention Type
Drug
Intervention Name(s)
12-O-tetradecanoylphorbol-13-acetate
Other Intervention Name(s)
TPA
Intervention Description
The initial dose of TPA will be 1 mg/week x 3 weeks (Day 1, 8, 15). Up to 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Other Intervention Name(s)
Dexamethasone sodium phosphate
Intervention Description
Dexamethasone 10 mg PO qid will start 24h prior to TPA and continue for 24h after TPA x 3 weeks. Up to 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Choline magnesium trisalicylate
Other Intervention Name(s)
Trilisate
Intervention Description
Choline magnesium trisalicylate 1500 mg PO TID will begin 24h prior to TPA and continue for 24h post TPA x 3 weeks. Up to 6 cycles.
Primary Outcome Measure Information:
Title
Response Rate > 20% for 12-O-tetradecanoylphorbol-13- Acetate (TPA)+ Dexamethasone + Choline Magnesium Trisalicylate(Trilisate)
Time Frame
42 months
Title
Grade 3 and 4 Non-hematologic Treatment-related Toxicity Rates < 25%
Time Frame
43 months
Secondary Outcome Measure Information:
Title
Effects of Treatment on Immunophenotype, Signaling Profile, and Nuclear NF-kB Expression
Description
Cycle 1 of treatment
Time Frame
48 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Must have a histologically documented relapsed/refractory AML for which there is no standard therapy that has been demonstrated to have curative or palliative potential. ECOG performance status of 0-2. Must be 18 years or older. Estimated life expectancy > 1 month. Laboratory data: total bilirubin ≤ 1.5 x upper limit of normal unless due to Gilbert's syndrome serum creatinine ≤ 2.0 mg/dl AST ≤ 3.0 x upper limit of normal Cardiac ejection fraction > 40% FEV1.0 > 50% predicted Prior therapy: > 3 weeks since chemotherapy, biological therapy or radiation; anticipated maximum hematological improvement since last dose of chemotherapy. (Concurrent hydroxyurea administration will be allowed to control WBC count, platelet count, or symptoms). No active infections. Negative pregnancy test for women of childbearing potential. No uncontrolled psychiatric illness or medical illness that the principal investigator feels will compromise the patient's tolerance of the study medication. Must provide informed consent. Exclusion Criteria Patients with an allergy to proton pump inhibitors, required for GI prophylaxis; or salicylates are excluded. Pregnant or lactating women Age <18 years. Because no dosing or adverse event data are currently available on the use of TPA alone or in combination with dexamethasone in patients < 18 years of age, children are excluded from this study but will be eligible for future pediatric Phase II combination trials. The effects of TPA on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation and for 10 weeks after. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Should the female partner of a participant in this study become pregnant or suspect she is pregnant during this study, the PI of this study will be available to provide advice about further medical/obstetric care/referral for the female partner. Patients with active CNS involvement (documented by radiographic lesions and/or malignant cells in the CSF) will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. Patients with treatment of any other investigational drug within the last 30 days prior to entering the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roger Strair, MD, PhD
Organizational Affiliation
Rutgers Cancer Institute of New Jersey
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rutgers Cancer Institute of New Jersey
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08903
Country
United States

12. IPD Sharing Statement

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Phase II Study of TPA Plus Dexamethasone & CMT in Hematologic Malignancies

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